Ectopic prostatic tissue in the uterine cervix and vagina - Report of a series with a detailed immunohistochemical analysis
Ectopic prostatic tissue in the uterine cervix and vagina - Report of a series with a detailed immunohistochemical analysis
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DOI：
10.1097/01.pas.0000180446.17517.b8
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发表时间：
2006-02-01
影响因子：
5.6
通讯作者：
Rollason, TP
中科院分区：
文献类型：
--
作者：
McCluggage, WG;Ganesan, R;Rollason, TP
女性下生殖道中的前列腺组织很少被描述。我们描述了 6 例异位前列腺组织：5 例涉及子宫颈，1 例涉及阴道。后者是第一个报道的阴道良性前列腺组织的例子。患者年龄从21岁到65岁不等；在所有情况下，前列腺组织均位于宫颈或阴道间质内，不涉及表面。在所有病例中，都存在腺体和鳞状成分，其突出程度各不相同。在某些情况下，鳞状成分占主导地位，以至于下面的腺成分很容易被忽视。在腺体区域，管腔细胞和基底细胞的双细胞层非常明显。几乎没有细胞学异型性或有丝分裂活性。免疫组化结果显示，6例中前列腺特异性抗原（PSA）阳性3例，6例前列腺酸性磷酸酶（PSAP）均呈阳性。在一些阳性病例中，染色是焦点。前列腺标记物的阳性染色仅限于腺体成分，鳞状区域没有染色。使用高分子量细胞角蛋白 34 β E12 进行的免疫组织化学染色突出显示了基底细胞层，该层通常延伸到细胞岛的中心，让人想起涉及前列腺的基底细胞增生。所有测试病例均为 CD10 阳性（主要局限于基底细胞层）、α-甲基酰基辅酶A消旋酶阳性和 p 16 阴性。腺区雌激素受体（ER）和孕激素受体（PR）均为阴性，但鳞状细胞ER均呈阳性，1例PR呈阳性。所有测试的病例均为雄激素受体阳性，并表现出较低的MIB-1增殖指数，仅有散在的阳性细胞核。女性下生殖道异位前列腺组织的存在可能比人们想象的更为常见。一旦考虑到这种可能性，使用免疫组织化学即可轻松确认诊断，尽管前列腺标志物染色可能是局灶性的且 PSA 可能呈阴性。根据形态学（包括双细胞层的存在），女性下生殖道中的异位前列腺组织几乎可以肯定是良性病症，尽管需要对大量病例进行随访。可能的组织发生理论包括发育异常、先前存在的宫颈内膜腺的化生以及中肾残余的衍生。
Prostatic tissue has rarely been described in the lower female genital tract. We describe 6 cases of ectopic prostatic tissue: 5 involving the cervix and I the vagina. The latter is the first reported example of benign prostatic tissue in the vagina. The age of the patients ranged from 21 to 65 years; and in all cases, the prostatic tissue was located within the cervical or vaginal stroma without involvement of the surface. In all cases, there were both glandular and squamous elements, which varied in prominence. In some cases, the squamous elements predominated to such an extent that the underlying glandular component was easily overlooked. In the glandular areas, a double cell layer of luminal and basal cells was focally apparent. There was little cytologic atypia or mitotic activity. Immunehistochemically, 3 of 6 cases were positive with prostate specific antigen (PSA) and all 6 cases marked with prostatic acid phosphatase (PSAP). In some of the positive cases, staining was focal. Positive staining with prostatic markers was confined to the glandular elements with no staining of the squamous areas. Immunohistochemical staining with the high molecular weight cytokeratin 34 beta E12 highlighted the basal cell layer, which often extended into the center of the cellular islands, reminiscent of basal cell hyperplasia involving the prostate gland. All cases tested were CD10 positive (largely restricted to the basal cell layer), alpha-methylacyl-CoA racemase positive, and p 16 negative. Estrogen receptor (ER) and progesterone receptor (PR) were negative in the glandular areas, but ER was positive in the squamous elements in all cases and PR was positive in 1 case. All cases tested were androgen receptor positive and exhibited a low MIB-1 proliferation index with only scattered positive nuclei. The presence of ectopic prostatic tissue in the lower female genital tract may be more common than is appreciated. Once the possibility is considered, the diagnosis is easily confirmed using immunohistochemistry, although staining with prostatic markers may be focal and PSA may be negative. Ectopic prostatic tissue in the lower female genital tract is almost certainly a benign condition, based on the morphology, including the presence of a double cell layer, although follow-up of larger numbers of cases is required. Possible theories of histogenesis include a developmental anomaly, metaplasia of preexisting endocervical glands, and derivation from mesonephric remnants.